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� ::?l•'�E ,.. �'+,,� <br /> APPLICI�:`�`ION FOR CONSTR4�:TION <br /> i PERMIT <br /> � Ihe Evarpraen <br /> ��� GTY OF everett <br /> ' ev�rett @ <br /> j BUILDING DEPARTMENT <br /> I 259•8810 TO BE COMPLETEID IN INK— PLEASE PRINT <br /> I qyHEp MAILAOORE55 CITY ZIf` PMONE <br /> I /hqB£z CO/JKL/nl /8�S .L U.'h/f•4r�D EU^.�: %b'7 0; 2.S% - /z�Ls <br /> � TENANT MRILR�DRESS CITY ZIP PNONE <br /> � <br /> i �pCN11ECTOR0E51GNER MAILRO�RE55 CITY ZIP PMONE <br /> I <br /> I <br /> I �ENERALCONTR�GTOR MRILAOOPE55 CITY ZIP PHONE LICENSE• <br /> � �c-S�cv ru, �o,�sr,�o�r,�Y.� is�.�2� a��/ .��,: «s��. �`d� �� «z-���z Ur.SiGr�/26P) <br /> � MECH�NIC�ICONiHPCtOR MMLR�ORE55 CITY 21P PHONE LILENSE• <br /> � �/ANSU'N �LUihC/,v4 MetO_. YrPz 7b 6�f- S`2=� <br /> � PLUMBINOCONTRpCIOR MNLROOfiE55 CITY 11P PIIONE I.ICEN9f:• <br /> l <br /> f.V�90F WORK <br /> ❑ NEW ❑ ADDI710N ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILOING RELOCATION <br /> � TENFNTIMPROVEMENTONINi=RIOfiFEMO�ELONLY CONTAGTPEfi50NANOPHONENO. <br /> I [/ �v / <br /> CANTRRCTPPICEOFWORk /� � '� M/KE' �e"/ "S2 ' �Z �L Z-' <br /> UESCRIBE WOPN AND SOORNE FOOT�GE INVOLVED <br /> i BATH RErneaez ��'��� �E�Aa� f ��/Sc. <br /> PROPoSED USE OF BUIL�ING I HEREOY CERTIFY THAT I HAVE READ AND ERAMINED THISl�?PIICATION AND <br /> S �/�\ KNOW THE SAME TO BE TriUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> �� LEa�LOEscairr�r+oFrROPERTY�SMOWNOELOWORATIAGHFOUiiCOPICS) �ADINANCESGOVERNINGTHISlYPEOFWOPKWILLBECOMPLETEDWITH <br /> WHEiHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> /q S 1�r7% CF E4GLC%% LYU/f/o PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPROVISIONSOF <br /> i �pT�. BLOCK�_ oF { ANYOTHERSTATEORLOCALL�WREGULATINGCONSTRUCTIONORTHEPER� <br /> �� ,/ ' FORMANCEOFCONSTRUCTION.THATIAMAUTHORIZFDBYTfIEOWNEROF <br /> � K CCRO. YO � � RK�H. -n /n! UUL� S OF �L THIS PROPEFN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH THE STATE CONTFiACTORS LAW 1B27 RCW AND <br /> � p 296200 WAC. <br /> � r , Sk10Ha lf ��N� SIGN4TUf1EOFCONIPRCiORORFUI110RRE�AGENi URTE <br /> ' 8 'LS LOM � .c.0 X //���VC 91��(!_.-, �'>A�c. /S`� /��/r <br /> i PROJECTF(t.0E55 PPPLICAflTSCITY USINESSLICENSENO.pN USINESSNAME <br /> � dEsie,u Tcu Co,�sr,cucr,v,J <br /> � PLUMAIIdG MECHANICAL <br /> � NO. TYPE OF FIXTURE Ofl ITEM FEE NO. NPE OF EOUIPMENT FEE <br /> � / WATERCLOSETITUILEf) AIC—A/HNDLGUNITS—H.P. <br /> / BATHTUB FORCEO AIR SYSTEMS—6T.U. M EA <br /> / LAVATORY�WASH BASIN) UNIT HEATERS—&T.U. M <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINKB DISP. VENTILATION FAN _ <br /> ! DISHWASHER FlANGE HOOD _ <br /> LAUNDRY TRAY WATER HEATER <br /> i CLOTHESWASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN f IRFPLACE INS�fiT <br /> FLOOR ORAIN FIEAT PUMP <br /> i — <br /> BACKFLOW PREVENTERS CAS PIPING <br /> I� qOOF DRAINS—RAINIEADERS ExHAUST FAN <br /> + SINK�SERVICE—BAR,ETQ) _ — <br /> ! <br /> i <br /> � SUBTOTAL $ SUBTOTAL S <br /> i PERMIT $ PERMIT S <br /> � TOTAL FEE S TOTAL FEE 5 <br /> � <br /> � FNONTaE7BRCK REA{ISE78RGK SIDESETBRCK PLANCNECKNUMBEP FEE PECEIITNO. <br /> � <br /> i USE20NE LO7AREA �pCr1NT51tE FEES VALUATION FEE <br /> ❑VES ❑110 <br /> i BUILDWG <br /> � TYPEOFGONST. OCGUPANCYGfiOUP NO.OFDWELLINGUNIiS <br /> � µLOW�BLE/ACTUpL PLUMBIMG <br /> i <br /> 312EOFBL�O. NO.Of5i0HIES BSMT. OCGLORD <br /> o v MEGHANICAL <br /> I ❑N <br /> HEIGMTLIMITAiION OTHEFi <br /> � <br /> � FIRESPRINNLEASREOUIPE� ❑YES ❑ NO <br /> � STATE BUILDING SURCFIARGE <br /> I <br /> STATE ENERGY SURCHARGE <br /> i <br /> MPL!CA710NAC0.8Y PLANSRPPp.9V <br /> i <br /> PUBLIC WORKS <br /> � � TOTAL <br /> i <br />